Fri Nov 25 2022

77 articles - From Friday Nov 18 2022 to Friday Nov 25 2022

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…


Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Systematic review: early feeding practices and the risk of coeliac disease. A 2022 update and revision.

For the population at genetic risk of CD, breastfeeding and age at gluten introduction have no effect on its cumulative incidence during childhood. There is some evidence for an effect of the amount of gluten consumed at weaning and/or thereafter on CD/CDA risk.

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Gastrointest Endosc

Early (<4 Weeks) Versus Standard (= 4 Weeks) Endoscopic Drainage of Pancreatic Walled-Off Fluid Collections: A Systematic Review and Meta-analysis.

Both early (< 4 weeks) and standard (= 4 weeks) drainage of walled off pancreatic fluid collections offer similar technical and clinical outcomes. Patients requiring endoscopic drainage should not be delayed for 4 weeks.

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Impact of Second-Generation Transoral Incisionless Fundoplication on atypical GERD symptoms: A Systematic Review and Meta-analysis.

Our study shows that TIF using the EsophyX device is safe and effective in reducing atypical GERD symptoms at 6- and 12-month follow-up. It improves patient-centered outcomes and can be a minimally invasive therapeutic option for patients suffering from atypical GERD symptoms on chronic medical therapy.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Deprescription of aspirin for primary prevention is uncommon at discharge in hospitalised patients with gastrointestinal bleeding.

Aspirin for primary cardiovascular prevention was rarely deprescribed at discharge in patients hospitalised with GIB. Processes designed to ensure appropriate deprescription of aspirin are crucial to improve adherence to guidelines, thereby improving the risk-benefit ratio in patients at high risk of subsequent GIB hospitalisations with minimal increased risk of MACE.

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Immune predictors of hepatitis B surface antigen seroconversion in patients with hepatitis B reactivation.

Non-seroconverters have increased inhibitory markers on CD4/CD8 T cells. There is a critical play of CD8, Tfh and B cells and subsets in seroclearance, along with checkpoint molecules as a potential therapy for non-seroconverters in HBV infection.

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Real-world comparison of effectiveness between tofacitinib and vedolizumab in patients with ulcerative colitis exposed to at least one anti-TNF agent.

Tofacitinib and vedolizumab are effective in UC after failure of anti-TNF agents. However, tofacitinib seems more effective, especially in severe disease and primary failure to biologics.

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The Liverpool alcohol-related liver disease algorithm identifies twice as many emergency admissions compared to standard methods when applied to Hospital Episode Statistics for England.

The LAA can be applied successfully to local and national datasets. It consistently identifies approximately 100% more cases than the standard coding approach. The algorithm has revealed the true extent of ArLD admissions. The pandemic has compounded a long-term rise in ArLD admissions and mortality.

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Am J Gastroenterol

Meditation and Yoga for Irritable Bowel Syndrome: A Randomized Clinical Trial.

Virtually delivered yoga is safe and feasible, and effective in reducing IBS symptoms. Based on the primary end point, the intervention was not superior to an advice-only control group.

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Clin Gastroenterol Hepatol

Abdominal Bloating in the US: Results of a Survey of 88,795 Americans Examining Prevalence and Healthcare Seeking.

Bloating is common in the community as nearly one in seven Americans have experienced this symptom in the past week. Women and those with certain comorbidities and concomitant GI symptoms are more likely to experience bloating and have more severe symptoms. Nearly one-third of sufferers that have not sought care are managing symptoms on their own or feel uncomfortable discussing it with their providers, emphasizing that efforts should be made to proactively inquire about bloating.

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Higher body mass index is associated with decreased treatment response to topical steroids in eosinophilic esophagitis.

As BMI increases in EoE patients, the odds of histologic, symptomatic, and endoscopic response to tCS decreases with obese patients having approximately 40% odds of response.

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Risk-Adapted Starting Age for Personalized Colorectal Cancer Screening: Validated Evidence from National Population-Based Studies.

We determined a risk-adapted CRC screening starting age for individuals with various CRC risk factors. Earlier, personalized screening based on these findings could allow for scarce health resources to be dedicated to individuals who benefit most.

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Endoscopy

Does a response to botulinum toxin injection predict a future response to peroral pyloric myotomy (POP) in patients with gastroparesis?

Clinical improvement after BTI is a predictor of response to POP in patients with gastroparesis. This information may aid in improving patient selection for POP.

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Efficacy and safety of intensive endoscopic intervention for multiple duodenal adenomas in patients with familial adenomatous polyposis: A prospective cohort study.

Intensive endoscopic intervention, including new-generation procedures, showed significant downstaging with acceptable adverse events for MDA in FAP patients, even those with advanced-stage disease. Lesion selection for different resection techniques may be important for suitable and sustainable management of MDA in FAP patients (Trial Reg Num UMIN000022525).

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Gastroenterology

Dysregulated amino acid sensing drives colorectal cancer growth and metabolic reprogramming leading to chemoresistance.

Our findings suggest a critical role of amino acid sensing pathways in driving CRC and highlights translational implications of dietary protein intervention in CRC.

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Hepatocyte Kctd17 inhibition ameliorates glucose intolerance and hepatic steatosis caused by obesity-induced Chrebp stabilization.

Srebp1c-induced hepatocyte Kctd17 expression in obesity disrupted glucose and lipid metabolism by stabilizing Chrebp, and may represent a novel therapeutic target for obesity-induced T2D and NAFLD.

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Loss of SUV420H2-dependent chromatin compaction drives right-sided colon cancer progression.

Loss of Suv4-20h2-mediated H4K20me3 drives right-sided colorectal colorectal tumorigenesis through an epigenetically controlled mechanism of chromatin compaction. Our findings unravel a conceptually novel approach for subtype specific therapy of this aggressive form of colorectal cancer.

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N-glycosylation regulates intrinsic IFN- resistance in colorectal cancer: implications for immunotherapy.

Together, our results demonstrated that tumor-associated changes in N-glycosylation destabilize IFNRa, causing IFN--resistance in CRC. IFN- sensitivity could be reestablished through the increase in MGAT3 expression, notably via ATRA treatment, providing new prospects for the treatment of immune-resistant CRC.

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Gastrointest Endosc

Adverse events of endoscopic full-thickness resection: results from the German and Dutch nationwide colorectal FTRD registry.

Colorectal eFTR is a safe procedure with a low risk for severe AEs in everyday practice and without AE-related mortality. These results further support the position of eFTR as an established minimally invasive technique for complex colorectal lesions.

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Comparison of EUS-guided ablation and surgical resection for non-functioning small pancreatic neuroendocrine tumors: a propensity score matching study.

EUS-EA had fewer complications and a shorter hospital stay with similar overall and disease-specific survival rates compared to surgery, suggesting that EUS-EA may be a preferred alternative to surgical resection in selected patients with a non-functioning small PNET.

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Establishment of Modified Kyoto Classification Scoring Model and its Significance in the Diagnosis of Helicobacter pylori Current Infection.

The modified Kyoto classification scoring model improves the accuracy of endoscopic determination of Hp current infection and has clinical application potential in Chinese population.

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Interobserver Agreement of Modified Paris Classification and Histology Prediction of Colorectal Lesions in Patients with Inflammatory Bowel Disease.

This study demonstrates very low IOA for Paris and Modified Paris classifications and low accuracy and IOA for lesion histopathology prediction. Revisions of these classifications are required to create a clinically useful risk stratification tool and enable eventual application of augmented intelligence tools.

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J Hepatol

A prospective study on the prevalence of NAFLD, advanced fibrosis, cirrhosis and hepatocellular carcinoma in people with type 2 diabetes.

Utilizing a uniquely well-phenotyped prospective cohort of patients aged = 50 years with T2DM, we found that the prevalence of advanced fibrosis was 14% and cirrhosis was 6%. These data underscore the high risk of advanced fibrosis/cirrhosis in adults = 50 years with T2DM. Impact and implications Nonalcoholic fatty liver disease (NAFLD) is common in patients with type 2 diabetes (T2DM), however, there are limited prospective data characterizing the prevalence of advanced fibrosis and cirrhosis using the most accurate non-invasive biomarkers of liver fat and fibrosis. We show that 14% of older adults with T2DM have advanced fibrosis and 6% have cirrhosis, which places them at risk for liver failure and liver cancer. Accurate prevalence rates and comparative analysis regarding the diagnostic accuracy of non-invasive tests in this population will guide the optimal screening strategy and future cost-effectiveness analysis. These results will inform future Hepatology and Endocrinology practice guidelines regarding NAFLD screening programs in older adults with T2DM.

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Longitudinal changes in fibrosis markers are associated with risk of cirrhosis and hepatocellular carcinoma in non-alcoholic fatty liver disease.

Longitudinal changes in non-invasive tests for liver fibrosis such as FIB-4 was strongly associated with progression to cirrhosis and HCC. Impact and implications Risk stratification tools for developing HCC in patients with NAFLD are lacking. Fibrosis-4 (FIB-4) scoring, is a widely available non-invasive test for liver fibrosis, a primary determinant for developing cirrhosis and HCC. In a large retrospective cohort of NAFLD patients, we found that serial changes in FIB-4 over time was strongly associated with progression to cirrhosis and HCC. Integrating serial measurements of non-invasive tests for fibrosis in the care pathway for patients with NAFLD can help tailor HCC risk prevention.

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Prospective surveillance for cholangiocarcinoma in unselected individuals with primary sclerosing cholangitis.

In an unselected cohort of PSC patients, yearly CA19-9 and MRI/MRCP surveillance followed by ERCP was ineffective in detecting cancer early enough to provide long-term survival. Given the low occurrence of CCA, studies on individualized strategies for follow-up and improved diagnostic methods for PSC-CCA are warranted. Impact and implications A prospective nationwide 5-year study was conducted to evaluate yearly surveillance with magnetic resonance imaging (MRI) and CA19-9 in patients with primary sclerosing cholangitis. Only 2% of the patients were diagnosed with cholangiocarcinoma during follow-up with a poor prognosis. This surveillance strategy was ineffective to detect cancer early enough to provide long-term survival.

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Value of threshold growth as a major diagnostic feature of hepatocellular carcinoma in LI-RADS.

The revised threshold growth of LI-RADS v2018 was significantly associated with HCC. Use of threshold growth as a major feature can improve the sensitivity for diagnosing HCC. Impact and implications We found that the revised threshold growth in the Liver Imaging Reporting and Data System version 2018 was a significant predictor of hepatocellular carcinoma (HCC). The use of threshold growth as a major imaging feature significantly increased the sensitivity of diagnosing HCC, especially small HCC (=3.0 cm), compared with its non-use. Because these small HCCs are eligible for curative treatments, the additional detection of small HCCs would be clinically meaningful.

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Neurogastroenterol Motil

A novel MRI-based three-dimensional model of stomach volume, surface area, and geometry in response to gastric filling and emptying.

The presented model offers a detailed tool for evaluating gastric volumes, surface geometry, and wall tension in response to filling and emptying and will provide insights into gastric emptying and accommodation in diseases such as diabetic gastroparesis.

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Regulation of the central amygdala on intestinal motility and behavior via the lateral hypothalamus in irritable bowel syndrome model mice.

The CeA-LHA GABAergic pathway might participate in the occurrence and development of IBS by regulating orexin-A neurons.

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Revised spectral metrics for body surface measurements of gastric electrophysiology.

The revised metrics resolve critical pitfalls impairing the performance of traditional EGG, and should be applied in future BSGM spectral analyses.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Gastroenterology

Promote or prevent? Gut microbial function and immune status may determine the effect of fiber in IBD.

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Shining a Light on Barrier Function.

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Gastrointest Endosc

Reflections on Gastrointestinal Endoscopy: 8 years of editorship.

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J Hepatol

Integrating cytotoxic, targeted and immune therapies for cholangiocarcinoma.

We are therefore facing a change of paradigm, where immunotherapy, cytotoxic chemotherapy and targeted therapies will complement each other when administered concomitantly. This review will focus on the rational behind these combinations and summarise current clinical trial data.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Clin Gastroenterol Hepatol

A (not so) rare cause of obscure GI bleed in elderly.

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The protection conferred by HSD17B13 rs72613567 on hepatic fibrosis is likely mediated by lowering ballooning and portal inflammation.

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Wandering Spleen: an unusual cause of recurrent abdominal pain.

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Endoscopy

A novel triangle traction method using a clip-band traction device for endoscopic submucosal dissection of early gastric cancer involving the pyloric ring.

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A three-color marking method to prevent stent migration in endoscopic ultrasound-guided drainage for peripancreatic fluid collections.

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Combining endoscopic mucosal resection with hybrid argon plasma coagulation to reduce local colorectal lesion recurrence: a video tutorial.

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Diagnosis of an unexpected colonic submucosal lesion by double-clip traction endoscopic submucosal dissection.

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Endoscopic management of a special case of "stone-basket impaction" during ERCP.

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Endoscopic ultrasound-guided choledochojejunostomy using a forward-viewing echoendoscopic saddle-cross technique.

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Endosonographic visualization of a mediastinal pancreatic pseudocyst.

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Gastric endoscopic muscularis dissection using a partial intramuscular injection technique.

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Novel blunt dissection forceps for tunnel creation during peroral endoscopic myotomy.

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Pharyngeal endoscopic submucosal dissection for a pyriform sinus lesion extending beyond the arytenoid to the vocal folds.

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Polyglycolic acid sheet with clipping for closing delayed perforation after colonic endoscopic submucosal dissection.

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Rapid hemostasis using a self-assembling peptide matrix for midprocedural bleeding in endoscopic sphincterotomy.

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Rendezvous in WONderland: combined percutaneous and transluminal approach for an undrained area of massive walled-off necrosis.

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Simultaneous incision and suturing of a large wound in the full-layer resection of stromal tumor under the traction of a snare -- a new method of endoscopic suturing.

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Single-balloon-assisted endoscopy with peroral pancreatoscopy and electrohydraulic lithotripsy.

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Snare traction and endoscopic suturing can improve endoscopic management of gastrointestinal stromal tumors at the gastric greater curvature.

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Underwater endoscopic submucosal dissection of a relapsing neoplastic colorectal lesion after surgery and radiotherapy: water to the rescue!

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Gastroenterology

Diarrhea, Colonic Stenoses and a Kinase Inhibitor.

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Guardian, Intermediary, or Perpetrator? New insights into environmental exposure, the gut microbiome, and NAFLD.

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Moderate fluid resuscitation is preferable in acute pancreatitis.

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New Sections in Gastroenterology-Gastro Curbside Consult and Gastro Grand Rounds.

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OrganEx: a Promising solution for Rescuing Organs following Prolonged Ischemia.

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The AGA Equity Project: Where We Are, and Where We Go From Here.

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Gastrointest Endosc

Endoscopic Ampullectomy of Sporadic Ampullary Adenoma.

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Top Tips: Endoscopic Biliary Stenting for Hilar Obstruction.

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Gut

Measuring size of smaller colorectal polyps using a virtual scale function during endoscopies.

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Letters&Replies

Letters to the editors and authors’ replies

Clin Gastroenterol Hepatol

Checking the absence of inflammatory activity with an objective marker, a key point to succeed the switch from intravenous to subcutaneous infliximab in inflammatory bowel disease.

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Concentrating on the long topic of empirical or not conventional Helicobacter pylori eradication regimens: authors' reply.

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Hybrid endoscopic submucosal dissection for early gastric neoplasms: an ideal technique?

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Letter to the editor: Intensive Lifestyle Management Improves Steatosis and Fibrosis in Pediatric Nonalcoholic Fatty Liver Disease.

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Gastroenterology

Comments on "Diversity, Equity, and Inclusion in Gastroenterology and Hepatology: A Survey of Where We Stand".

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The Case for FLIP Panometry in Clinical Practice.

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Gastrointest Endosc

A potential impact of Helicobacter pylori-related metabolic syndrome on early and long-term outcomes of bariatric surgery.

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Artificial intelligence-assisted cholangioscopy for automatic detection of malignant biliary strictures.

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Caution should be exercised in denying the protective effect of clip closure on post-EMR perforation of a proximal large nonpedunculated colorectal polyp.

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Influence of learning curve and perioperative factors on the clinical success of gastric peroral endoscopic myotomy.

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Obtaining slight changes for the detection of nonerosive reflux disease needs assistance from magnifying endoscopy with narrow-band imaging.

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Gut

Response to: Correspondence on 'On the ethics of digestive health research in historically marginalised communities' by Velez and Targownick.

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J Hepatol

Albumin for Liver-Brain Outcome Improvement Across Different Situations in Cirrhosis.

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Biejia-Ruangan compound and incidence of hepatocellular carcinoma.

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The concept of MAFLD gathers patients with distinct disease progression trajectories.

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Title: On Building a Better Mousetrap Response to: "Towards Optimally Replacing the Current Version of MELD".

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